Provider Demographics
NPI:1972863801
Name:PAVLOVIC, JELENA (MD)
Entity type:Individual
Prefix:
First Name:JELENA
Middle Name:
Last Name:PAVLOVIC
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1575 BLONDELL AVE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2660
Mailing Address - Country:US
Mailing Address - Phone:718-405-8360
Mailing Address - Fax:718-405-8369
Practice Address - Street 1:1575 BLONDELL AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2660
Practice Address - Country:US
Practice Address - Phone:718-405-8360
Practice Address - Fax:718-405-8369
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY60 2626422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology